Conflicting Advice on Healthy Salt Consumption Levels

too much salt?

image: Forbes

One of the biggest problems we consumers have with nutrition, is the seemingly ever changing and conflicting advice dispensed to us from experts. Fat was once evil, now it’s not. Eggs were the devil, now they are not.

Will salt be the next nutrient to experience a renaissance?

Salt, or more precisely, the sodium in salt, is a required nutrient for proper bodily function. The problem is that we consume too much, to the point of deleterious health effects such as high blood pressure. For years, we’ve been told that our American diet is too high in sodium and that we must reduce consumption. The average American eats food with 3,400 milligram of sodium, while the recommended maximum level is 2,300 mg. For some populations (African Americans, people over the age of 50, people with chronic disease such as diabetes) the maximum level recommended is 1500 mg. These groups account for almost 50% of the population.

The Institute of Medicine (IOM) was recently commissioned by the Center for Disease Control (CDC), to review studies on the matter.  The group found  faults in study design and comparisons among the various studies that led to potentially wrong recommendations. An IOM report released yesterday, may have just thrown a wrench into current sodium intake guidelines:

“These new studies support previous findings that reducing sodium from very high intake levels to moderate levels improves health,” said [IOM] committee chair Brian Strom, George S. Pepper Professor of Public Health and Preventive Medicine at the University of Pennsylvania Perelman School of Medicine.

Here’s the “wrench” part:

“But they also suggest that lowering sodium intake too much may actually increase a person’s risk of some health problems.”

More precisely, the IOM states:

The healthy, young population should reduce sodium intake to the 2,300mg level. Reduction to the 1,500mg level does not seem to have any positive or negative effects. Further research is required.

The subgroups (African American, those over 50, people with diabetes, heart issues, and kidney disease should reduce sodium intake to 2,300mg. Reduction to the 1,500mg level does not seem to have any positive or negative effects. Further research is required.

For only one specific subgroup – people with with mid- to late-stage heart failure who are receiving aggressive treatment for their disease – reduction below 2,300mg may have adverse health effects.

Bottom line: unless you are receiving aggressive treatment for advanced heart disease, you must reduce your sodium intake to the 2,300mg mark, and can reduce it further to 1,500mg. The easiest way to reduce sodium intake is to eat less processed foods. Cook at home.

  • Mike Luque

    One piece of information I found in the NY Times story about this I found really interesting: “As sodium levels plunge, triglyceride levels increase, insulin resistance increases, and the activity of the sympathetic nervous system increases. ”

    I didn’t know that information at all.

    However, who actually sits around and measures their sodium intake to such refined levels? If we don’t purposely add salt to our home cooked food and we rarely eat heavily processed food, are we not eating enough sodium?

    • Fooducate

      Reduction in heavily processed foods and out of home dining is probably the best course of action for most Americans. If all of us suddenly followed this advice, it would be a severe economic shock to the food industry…

  • Brian Klein

    My biggest problem with these messages is that they tell you to stop reaching for the salt shaker… the salt shaker isn’t the problem. Like you say, it’s the processed foods. If we all just ate more home cooked meals, and salted them to taste with a salt shaker, there’d be no way we would eat too much salt.

    Also, most people eat highly processed salt that is devoid of trace minerals. Using salts such as Himalayan, sea salt, etc, is also another way to increase the health benefits of eating salt.

  • Thomas Townsend

    The one very important aspect that is ALWAYS overlooked in these studies has to do with H2O. If your water intake is sufficient to balance out the sodium – then it’s not an issue. The problem is not so much the sodium intake, as it is we don’t drink enough regular water. As an athlete in my 50′s, my average sodium intake is between 3-5K mg. However, I drink over a Gallon of water a day. No Problems and don’t ever see one as long as I keep the ratio in check. Lets start talking about drinking more water thanattempting to limit salt/sodium intake.

  • Tiffany

    Every single medical study that I have read is on isolated sodium chloride…not real salt as it exists everywhere in nature. Real salt (ie Himalayan and Celtic sea salt, just to name two) are chalk full of minerals. Himalayan (over 84 trace minerals at 2%) and celtic sea salt (france) at 12%. That’s a lot of minerals. Give me a real study that studies real salt and then I will listen.

  • The Candid RD

    Salt and eggs are two topics I just don’t know about….are they good? are they bad? are they ugly? haha, jk. I think I’ll stick with my 1 tsp. rec. for clients. I’ve been known to get down to 100 mg and felt like crap (dizzy and tired), it can be dangerous, but 2300 mg is a good rec, and that in itself is hard enough for many people!